DR. TAMMY LYNN JACKSON PH.D. NPI 1619958758

NPI Information

NPI: 1619958758
Provider Name: DR. TAMMY LYNN JACKSON, PH.D.
Classification: Psychologist - 103TA0700X
Entity Type: Individual

Specialization: Adult Development & Aging

PECOS Registration: Yes

Address:
1014 SUN MEADOW CT
COLLEGE STATION, TX
ZIP 77845
Phone: (979) 217-1311
Get Directions

DR. Tammy Lynn Jackson, PH.D. is an adult development and aging psychologist in College Station, TX. The provider is a psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care. DR. Tammy Lynn Jackson, PH.D. NPI is 1619958758. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1014 SUN MEADOW CT
COLLEGE STATION, TX
ZIP 77845-291
Phone: (979) 217-1311
Fax: (855) 604-0969

The NPI 1619958758 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 11/7/2005 and was last updated on 8/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TB0200X	Psychologist	Cognitive & Behavioral	31418	TEXAS	No
2	103TC1900X	Psychologist	Counseling			No
3	103TA0700X	Psychologist	Adult Development & Aging	31418	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	158249604	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »